Incompatible With Life:
A MEMOIR OF GRAVE ILLNESS, GREAT LOVE, AND SURVIVAL
INTRODUCTION: FILL THE PAGES WITH LIGHT
Irish Repertory Theater, New York City, 1998 / Ristorante Gradisca, Greenwich Village 2015
Half a lifetime ago, I met Frank McCourt, author of Angela’s Ashes, at the Irish Repertory Theater in New York City. During our brief conversation, he offered advice I never thought I’d use.
Yet, in the fullness of time, I have – with this book.
Frank was one of the playwrights for the show that evening and the Irish Rep is an intimate house where patrons and principals tend to mingle once the lights come up, so I knew our paths might cross. Sure enough, in the gaggle after the performance, a mutual friend made the introduction.
At the time, Frank was the absolute toast of the town. His first book, that stunning memoir of a materially impoverished and spiritually challenging childhood in Limerick, had recently won the 1998 Pulitzer Prize for Literature. This unassuming 66-year-old man – someone you’d not have glanced at on the subway a year before – was now everywhere in the news. He was on magazine covers and talk shows, and all the bookstores had his genius work front-shelved as you walked through the door. For all that, I didn’t want to be just another in the endless string of admirers lauding his artistry, so as I reached to take his hand, I steered our conversation toward commoners’ ground.
Before picking up the pen, Frank taught English at Stuyvesant High School in Manhattan. I was a Social Studies teacher in Brooklyn at the time, so I greeted him collegially and asked if he ever missed the classroom.
Frank responded in the endearing, disarming accent of his home across the sea.
“Oh, for sure, for sure, I miss the students. I miss the teaching. There’s nothing like young minds to keep you on your toes. But the administration? Bah. Glad to be shed of them. And yourself, boyo? How long ya been in the system?”
I told him I’d been teaching for five years.
The news gave him an oddly pained look, prompting a question entirely out of the blue – for anyone but a fellow New York City public school teacher.
“Five years, eh? So, what Tier are ya, son?”
I chuckled. One of the great storytellers of our age had just asked about my pension plan.
“Tier IV, Frank,” I said with some dejection.
He shook his head slowly and said with genuine concern, “That’s a bad billet, boyo. A bad billet. You can’t retire on a Tier IV pension! You just can’t do it. It’s a pauper’s pension, son.”
He wasn’t wrong. Also, he was so naturally affable and open that I responded like an old friend.
“What the hell can I do about it, Frank? I didn’t negotiate the contract. It was you older bastards who sold us younger fellas out.”
He nodded sagely, empathetically. Then he placed a hand on my shoulder and said, “True enough, boyo. But if you’ll listen to me, I’ve got a notion for ya.”
Now that was something. Frank McCourt had a notion! For me! I leaned in close.
He leaned in, too. Then – at a volume clearly audible to everyone standing nearby – he stage-whispered, “I’m not sure if you’ve heard, son, but I recently wrote meself a wee book – and it’s going gangbusters! Maybe you’ll want to be giving that a whirl. Write yerself a book! You’ll make a fortune!”
Then he slapped my shoulder and beamed.
Along with the eavesdroppers nearby, I laughed out loud. I’d tried to avoid Frank’s fame, and he’d driven us back to it with a grin. The subject now broached, I utterly gushed. I told him that, of course, I’d read “his wee book.” Everyone had. Then I praised it up, down, and sideways, claiming it to be “among the finest stories written since the Evangelists scored a four-book deal.”
He liked that line. He liked that a lot.
When I’d run out of praise, Frank thanked me for taking the time to read his life story, noting that “without an audience, an author is the loneliest animal on earth.”
Then he returned, more seriously, to the idea of me writing a book someday.
“You can turn a phrase, boyo – and the world always needs more stories.”
I promised him if I ever lived one worth telling, I’d be sure to write it down.
“Good lad,” said he.
The director then nudged through the crowd, heading toward our small conversational knot, and it was clear Frank would soon have to turn toward the next group of admirers. I didn’t want to monopolize his time, but before we parted, I dove in for a final bit of charm.
“If I write the book, Frank, what’s your best advice?”
Quick as he could, he shot back his answer.
“Make the title dark – but fill the pages with light.”
Then he winked and said, “People love that.”
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“Incompatible With Life” is among the darkest terms in the medical lexicon. Physicians use it – far from patients’ ears, mind you – to describe those of us with vanishingly little chance of survival. Consider it this way: If someone threw you off the roof of a skyscraper, you’d be alive until you hit the ground. But a physician observing from a window on the fifty-ninth floor could rightly conclude that, given your situation and the laws of physics, you’re almost certainly “incompatible with life” past the next couple of seconds.
Two months after my discharge from the hospital, I learned that’s how I’d been described by doctors close to my care.
A physician friend shared this story over dinner at our favorite Italian joint in Greenwich Village once I’d regained enough strength to sit through a meal. At the time, I was gaunt and heart-weak, and the five-block walk to the restaurant required three rest stops, but I was there. As the waiter brought our mains, my friend asked if I remembered her visit to the hospital back in March.
I said I had a pleasant, hazy recollection of the day.
That’s not what she remembered at all.
Standing at my bedside on the cardiac ward of Mount Sinai Hospital, aghast by what she saw, my friend conducted an impromptu, cursory examination of my condition, noting my pallor, respiration, pulse, and mental focus – all of which were disasters. It was hard for her to square my state with the world she knew. We’d shared a meal at this very restaurant only a few months before. Yet, even with her diagnostic tools limited to a brief conversation and a quick visual appraisal, she could see that something had gone terribly wrong inside my body, and I was most certainly dying. After twenty years of friendship, it was too much to bear.
She gave me a quick kiss goodbye and rushed from the room, not wanting me to see her cry.
After composing herself by the nurses’ station in the hallway, a resident walked past on his rounds. My friend buttonholed him, introducing herself as a colleague from Memorial Sloan Kettering Cancer Center across town. Then she asked if he would allow her to review my chart as a professional courtesy. While unlikely, perhaps she’d spot something the other doctors missed. The resident, open to anyone with a novel idea, agreed. Sadly, the medical records only confirmed her worst fears.
While the Mount Sinai doctors had recently isolated the mysterious, underlying cause of my collapse – a rare genetic condition called hereditary hemochromatosis – the facts remained: I was in profound heart, liver, and pancreatic failure with a partially collapsed lung, pericardial effusion, a blood clot in my left ventricle, and a list of other traumas deprioritized by the immediate threats to my life. Worse, I was too weak for the one treatment that might help – persistent and intensive bloodletting. There were no two ways about it – at 48 years of age, I’d been tossed off the tower and was heading for the sidewalk.
While my friend pored over the files, the resident provided the working hypothesis: “We can hope for the best, but beyond the next few days, we expect the patient to be incompatible with life.”
My friend, accepting reality, adopted the stoicism of her profession and concurred. Then, in silence, the two physicians parted. Nothing remained to be said.
Hearing all this in the restaurant, I froze – a forkful of farfalle inches below my open mouth. I knew I was lucky to be alive. I knew I’d been gravely ill. Still, the words “incompatible with life” jarred loose powerful internal gears, and from their turning, a narrative engine was born. Perhaps I had a story worth telling after all. One thing was sure: I’d just been gifted a deliciously dark title.
Two years later, when I’d finally rebuilt sufficient strength to write long-form in earnest, I knew there would be a thousand problems to solve – but cutting a path through the darkness would not be one. Though this story begins in tumult and passes through pain, loss, madness, impotence, frustration, humiliation, and shame, the destination – past the point of confronting and embracing mortality – was always one of beauty. It would have been, even if I’d died in the hospital.
Understanding that is the magic.
What I learned on my plummet toward death and through the unexpected rise that followed is worthy – I believe – of the unfolding chapters ahead. Yet, if you feel like bypassing these pages altogether, the central lesson of this journey is simple enough to fit in one line. It is simple enough to be remembered – and sung – along the steep arc of our inevitable fall toward the unforgiving ground: We’re not here for long, and our only purpose is to fill our pages – and our rapidly passing moments – with light.
Were he still with us, I’m certain Frank would agree.
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